Last week’s federal budget included a to get the ³Ô¹ÏÍøÕ¾ Disability Insurance Scheme (NDIS) ““. In the next four years, there are also plans for a $15.3 billion reduction in NDIS costs.
Authors
Libby Callaway
Associate Professor, Rehabilitation, Ageing and Independent Living Research Centre and Occupational Therapy Department, School of Primary and Allied Healthcare, Monash University
Natasha Layton
Senior Research Fellow: Rehabilitation, Ageing and Independent Living Research Centre, Monash University
One area of focus is , an that covers products – from – and the systems and services necessary for their delivery. Getting assistive technology right is vitally important for an effective NDIS because the return on investment is around . Assistive technology enables people to do what’s important to them, including work and study.
Pre-budget flagged this focus and the 2023-24 provides further detail. Reportedly, some in projected savings will come via initiatives including “preferred provider arrangements to leverage [NDIS] buying power” and an “assistive technology expert advisory panel”.
These targets are ambitious and there are important considerations for them to be successful.
Putting the person first
There are for assistive technology provision. The first is that the supply of assistive technology is , not product or service-centred. This is because to get good outcomes, should drive product selection, rather than a person’s needs being “fitted” to an existing product. The latter goes against and could worsen NDIS participant outcomes.
The value of committed in NDIS participant plans – $1.38 billion at the end of last year – points to an opportunity to exert buying power and save money. However, bulk buying assistive technology at discount prices could lead to unintended consequences.
Risks include product selection or inadvertent market price fixing.
It also means the government may wind up with a warehouse full of equipment waiting to be matched to a user, rather than the products scheme participants really require.
The current approach – using an evidence-based of product categories that guides NDIS participants and providers clarity on the options available – is more suitable.
For example, personal alarms can useful to alert others to the need for assistance but the reasons for assistance depend on the person. Disability-related needs, such as seizure and falls management, fire detection, alerts for phone calls or visitors, and orientation or memory prompts, should guide product selection.
The right advice can be complex and cost more
When assistive technology is , it is recommended participants seek advice from allied health professionals.
Some assistive technology advisory services – such as state-based Independent Living Centres – were lost when they that emerged when the NDIS was implemented.
This means people will most often get advice from product suppliers or when they contract advice from allied health providers. But hourly rates for allied health services funded by the NDIS have been labelled as “” by leaders including NDIS Minister Bill Shorten. The suggestion here is that the same service is being charged at a much higher rate for NDIS participants. But this is incorrect. It fails to take into account the complexity and cost of NDIS work, or gap amounts paid for other allied health services, like those provided through .
When it comes to assistive technology and home modifications, the trained technical expertise, necessary insurances, professional supervision and administrative processes required make delivery and costly.
For example, for an occupational therapist to codesign vehicle modifications with a wheelchair user, there are to deliver a good outcome.
NDIS participant and provider expertise should be central
There are reports that a proposal to bulk buy assistive technology would rely on an , something like the Pharmaceutical Benefits Scheme that negotiates medicine prices.
But expert advisory panels, such as those in other disability and , are typically staffed by health professionals.
NDIS participants must be . Any advisory panel should include people who use assistive technology, as well as health professionals who advise on it.
Nothing about us without (any) of us
The NDIS relies on informed and empowered participants and an effective and efficient provider market.
The most effective way to curb spending will be for the ³Ô¹ÏÍøÕ¾ Disability Insurance Authority (which administers the NDIS) to codesign processes with people with disability and their support network – sometimes called “” – and any advisers they choose to engage. They can help identify reasonable and necessary assistive technology and get the best value for money.
Libby Callaway receives funding from the Australian government Department of Health and Ageing, and the Transport Accident Commission in Victoria. She is the voluntary President of the Australian Rehabilitation and Assistive Technology Association, and a voluntary Board Director of The ³Ô¹ÏÍøÕ¾r Hack.
Natasha Layton receives funding from the World Health Organization and iLA (Independent Living Assessment, WA). She is a voluntary Board member with the Australian Rehabilitation and Assistive Technology Association, and the Global Alliance of AT Organizations, as well as representing Australian Standards to the ISO as an expert on assistive product classification and terminology.
